Aplicação de pesquisa e informação para políticas de recursos humanos: as metas regionais para as Américas

Objective Report experiences involving the use of research and information systems to support national human resources policies through benchmarking between different countries, with comparisons over time and between similar countries or regions. Method In 2007, the Pan American Health Organization (PAHO) promoted a set of goals for all the countries in the Americas to improve the situation of health human resources, using a uniform methodology and research process carried out by Observatories of Human Resources. Results The analysis focused on the progress made in relation to the main challenges in the Southern Cone countries, with a special emphasis on Brazil, noting improvements in the distribution of professionals in the regions. Conclusion These experiences showed how research and the use of information systems can stimulate the expansion of good practices in the training, retention and development of the health workforce in the Americas.Objetivo Relatar a experiência sobre o uso de pesquisas e sistemas de informação para apoiar as políticas nacionais de recursos humanos por meio de benchmarking entre diferentes países, com comparações ao longo do tempo ou entre países ou regiões semelhantes. Método A Organização Pan-Americana da Saúde (OPAS) promoveu em 2007 um conjunto de metas para todos os países das Américas para aprimorar a situação dos recursos humanos para a saúde, utilizando uma metodologia uniforme e um processos de pesquisa pelos Observatórios de Recursos Humanos. Resultados A análise se centra no avanço dos principais desafios nos países do Cone Sul, com especial ênfase no caso do Brasil, mostrando melhorias na distribuição de profissionais nos territórios. Conclusão A experiência mostrou como a pesquisa e o uso dos sistemas de informação pode impulsionar a ampliação das melhores práticas de formação, fixação e desenvolvimento da força de trabalho em saúde nas Américas.Objetivo Relato de experiencia sobre el uso de investigaciones y sistemas de información para ayudar en la formulación de políticas nacionales de Recursos Humanos por medio de benchmarking entre distintos países, con comparaciones a lo largo del tiempo o entre países o regiones similares. Método La Organización Panamericana de la Salud (OPAS) promovió en 2007 un conjunto de metas para todos los países de las Américas para mejorar la situación de los recursos humanos para la salud, utilizando una metodología uniforme e investigaciones a través de los Observatorios de Recursos Humanos. Resultados El análisis se enfoca en el avance de los principales desafíos en los países del Cono Sur, con especial énfasis en el caso de Brasil, mostrando progreso en la distribución de profesionales en los territorios. Conclusión La experiencia muestra como las investigaciones y los sistemas de información pueden impulsar la expansión de las mejores prácticas de formación, fijación y desarrollo de la fuerza de trabajo en salud en las Américas

Desafíos críticos de los recursos humanos en salud: una visión regional

This text presents the context and background, the methodology and some of the main results of the regional consultation on the critical challenges for human resources in health in the Americas. The Consultation, carried out in June and July 2005, was part of the strategy of the Pan American Health Organization (PAHO/WHO) for the organization of the VII Regional Meeting of the Observatories of Human Resources, held in Toronto (Canada). The main results and suggestions by the actors consulted with regard to the role of international cooperation in the countries of the Region are presented, so that the countries and international agencies can better formulate common strategies of development and strengthening of the work force in health.Este texto presenta el contexto y antecedentes, la metodología y algunos de los principales resultados de la Consulta Regional sobre los desafíos críticos de los recursos humanos en salud en la Región de las Américas. La Consulta, realizada en junio y julio de 2005, hizo parte de la estrategia de la Organización panamericana de Salud (OPS/OMS) para la organización de la VII Reunión Regional de los Observatorios de Recursos Humanos, realizada en Toronto (Canadá). Se presentan los principales resultados y las sugerencias formuladas por los actores consultados en relación al papel de la cooperación internacional en los países de la Región, a fin de que los países y las agencias internacionales puedan formular estrategias comunes de desarrollo y fortalecimiento de la fuerza laboral en el campo de la salud.Este texto apresenta o contexto e antecedentes, a metodologia e alguns dos principais resultados da Consulta Regional sobre os desafios críticos dos recursos humanos em saúde na Região das Américas. A Consulta, realizada em junho e julho de 2005, foi parte da estratégia da Organização Pan-Americana de Saúde (OPS/OMS) para a organização da VII Reunião Regional dos Observatórios de Recursos Humanos, realizada em Toronto (Canadá). São apresentados os principais resultados e algumas das sugestões encaminhadas pelos atores consultados em relação ao papel da cooperação internacional nos países da Região, a fim de que os países e as agências internacionais formulem estratégias comuns de desenvolvimento e fortalecimento da força de trabalho em saúde

Tracking pregnant women displacements in Sao Paulo, Brazil: a complex systems approach to regionalization through the emergence of patterns

Background The healthcare system can be understood as the dynamic result of the interaction of hospitals, patients, providers, and government configuring a complex network of reciprocal influences. In order to better understand such a complex system, the analysis must include characteristics that are feasible to be studied in order to redesign its functioning. The analysis of the emergent patterns of pregnant women flows crossing municipal borders for birth-related hospitalizations in a region of São Paulo, Brazil, allowed to examine the functionality of the regional division in the state using a complex systems approach and to propose answers to the dilemma of concentration vs. distribution of maternal care regional services in the context of the Brazilian Unified Health System (SUS). Methods Cross-sectional research of the areas of influence of hospitals using spatial interaction methods, recording the points of origin and destination of the patients and exploring the emergent patterns of displacement. Results The resulting functional region is broader than the limits established in the legal provisions, verifying that 85% of patients move to hospitals with high technology to perform normal deliveries and cesarean sections. The region has high independence rates and behaves as a “service exporter.” Patients going to centrally located hospitals travel twice as long as patients who receive care in other municipalities even when the patients’ conditions do not demand technologically sophisticated services. The effects of regulation and the agents’ preferences reinforce the tendency to refer patients to centrally located hospitals. Conclusions Displacement of patients during delivery may affect indicators of maternal and perinatal health. The emergent pattern of movements allowed examining the contradiction between wider deployments of services versus concentration of highly specialized resources in a few places. The study shows the potential of this type of analysis applied to other type of patients’ flows, such as cancer or specialized surgery, as tools to guide the regionalization of the Brazilian Health System

The interface between health sector reform and human resources in health

The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms. The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways – reacting to transformations, supporting, blocking and distorting the proposed ways of action. This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them

Desafios críticos dos recursos humanos em saúde: uma visão regional Desafíos críticos de los recursos humanos en salud: una visión regional Critical challenges for human resources in health: a regional view

Este texto apresenta o contexto e antecedentes, a metodologia e alguns dos principais resultados da Consulta Regional sobre os desafios críticos dos recursos humanos em saúde na Região das Américas. A Consulta, realizada em junho e julho de 2005, foi parte da estratégia da Organização Pan-Americana de Saúde (OPS/OMS) para a organização da VII Reunião Regional dos Observatórios de Recursos Humanos, realizada em Toronto (Canadá). São apresentados os principais resultados e algumas das sugestões encaminhadas pelos atores consultados em relação ao papel da cooperação internacional nos países da Região, a fim de que os países e as agências internacionais formulem estratégias comuns de desenvolvimento e fortalecimento da força de trabalho em saúde.<br>Este texto presenta el contexto y antecedentes, la metodología y algunos de los principales resultados de la Consulta Regional sobre los desafíos críticos de los recursos humanos en salud en la Región de las Américas. La Consulta, realizada en junio y julio de 2005, hizo parte de la estrategia de la Organización panamericana de Salud (OPS/OMS) para la organización de la VII Reunión Regional de los Observatorios de Recursos Humanos, realizada en Toronto (Canadá). Se presentan los principales resultados y las sugerencias formuladas por los actores consultados en relación al papel de la cooperación internacional en los países de la Región, a fin de que los países y las agencias internacionales puedan formular estrategias comunes de desarrollo y fortalecimiento de la fuerza laboral en el campo de la salud.<br>This text presents the context and background, the methodology and some of the main results of the regional consultation on the critical challenges for human resources in health in the Americas. The Consultation, carried out in June and July 2005, was part of the strategy of the Pan American Health Organization (PAHO/WHO) for the organization of the VII Regional Meeting of the Observatories of Human Resources, held in Toronto (Canada). The main results and suggestions by the actors consulted with regard to the role of international cooperation in the countries of the Region are presented, so that the countries and international agencies can better formulate common strategies of development and strengthening of the work force in health

Desafios críticos dos recursos humanos em saúde: uma visão regional

Este texto apresenta o contexto e antecedentes, a metodologia e alguns dos principais resultados da Consulta Regional sobre os desafios críticos dos recursos humanos em saúde na Região das Américas. A Consulta, realizada em junho e julho de 2005, foi parte da estratégia da Organização Pan-Americana de Saúde (OPS/OMS) para a organização da VII Reunião Regional dos Observatórios de Recursos Humanos, realizada em Toronto (Canadá). São apresentados os principais resultados e algumas das sugestões encaminhadas pelos atores consultados em relação ao papel da cooperação internacional nos países da Região, a fim de que os países e as agências internacionais formulem estratégias comuns de desenvolvimento e fortalecimento da força de trabalho em saúde

Genetics of vesicoureteral reflux

Primary vesicoureteral reflux (VUR) is the most common urological anomaly in children, affecting 1–2% of the pediatric population and 30–40% of children presenting with urinary tract infections (UTIs). Refluxassociated nephropathy is a major cause of childhood hypertension and chronic renal failure. The hereditary and familial nature of VUR is well recognized and several studies have reported that siblings of children with VUR have a higher incidence of reflux than the general pediatric population. Familial clustering of VUR implies that genetic factors have an important role in its pathogenesis, but no single major locus or gene for VUR has yet been identified and most researchers now acknowledge that VUR is genetically heterogeneous. Improvements in genome-scan techniques and continuously increasing knowledge of the genetic basis of VUR should help us to further understand its pathogenesis.Other funderChildren's Medical and Research Foundation6M embargo after publication - AV 8/9/2011 ke, SB-09/09/201